Growth spurt
Three years after that penning a strategic plan that united the vision of the UF Health Science Center and the UF Health Shands family of hospitals, UF Health is continuing to grow bigger and better
By April Frawley
In December, doctors will thread a tiny catheter into McKenna Brown’s heart. They will measure the blood pressure inside her heart and watch how blood flows in and out of its chambers. They will get a better picture of the congenital heart defects that have plagued McKenna since she was born at UF Health Shands Children’s Hospital in November 2008.
And when it is over, her team of physicians at the UF Health Congenital Heart Center will decide whether she can undergo another open heart surgery — necessary for children with her condition once they reach a certain size — or if she will need a heart transplant.
“Heart defects are like snowflakes — they are all different,” says Alyssa Brown, McKenna’s mother. “They are groupings of symptoms. With heart defects, there are so many variables as they grow. That is why the care plans are so individualized.”
McKenna’s defect, hypoplastic left heart ventricle, was discovered during an ultrasound, so Alyssa and her husband chose to have their daughter at UF Health Shands Children’s Hospital, where experts from the UF Health Congenital Heart Center could tend to her needs immediately after birth. She underwent her first open heart surgery at just 4 months old.
Depending on the outcome of her test in December, McKenna may need to spend up to a month in the hospital. Aside from offering topnotch cardiovascular care — the Congenital Heart Center is nationally ranked, according to U.S. News & World Report — UF Health is taking additional steps to provide even better care to tiny heart patients like McKenna and to improve their long stays in the hospital.
As part of the ongoing renovations to the UF Health Shands Children’s Hospital, the UF Health Congenital Heart Center will soon have a new specialized cardiac intensive care unit. Aside from offering more room for patients and their families — the rooms are about twice the size as current rooms — the unit also will feature the latest in cardiac care technology and will be staffed by physicians and nurses trained in cardiac care, says Mark Bleiweis, M.D., director of the Congenital Heart Center and its principal pediatric cardiothoracic surgeon.
“We have done such a good job even in the current system, but this will give us the opportunity to give our patients focused family care in excellent-sized rooms,” Bleiweis says. “We are going to have more space, more beds and more access. I think it is recognition of the great work that has been done here by our team of physicians and nursing staff. It is a statement about the commitment UF Health has about taking care of kids with CHD.”
The new cardiac intensive care unit is just one of many examples of how UF Health has been expanding in recent years. At a time when many academic centers are scaling back and even laying off employees — in September the Cleveland Clinic, Vanderbilt Medical Center and others all announced job cuts — UF Health is undergoing a period of tremendous growth.
“Growth is more of a consequence than a goal,” says David S. Guzick, M.D., Ph.D., the UF senior vice president for health affairs and president of UF Health. “When you bring a hospital and university faculty together to create an excellent environment, united by one mission, then the growth follows.”
In August, alone, UF Health leaders announced plans to build a new hospital tower dedicated to cardiovascular care and neuromedicine. UF Health Jacksonville broke ground on a new medical facility in North Jacksonville, and Gainesville staff celebrated the grand openings of the new Clinical and Translational Research Building and the UF Health Pediatrics office at Magnolia Parke.
Renovations are already underway to UF Health Shands Hospita lfor Children— including the new cardiac intensive care unit. Construction will begin on a new Medical Education Building in November, and in recent years, new research and academic facilities have opened in Gainesville and Orlando.
The building boom is just one part of UF Health’s expansion, and is a hallmark of the academic health center’s true goal — achieving excellence in patient care, research and education. It’s a cyclical process, Guzick says. Improved spaces and specialized units allow UF Health to recruit top faculty members. Highquality physicians and research leads to increased demand and a need for more space. Top-notch faculty members and buildings also help improve the quality of education students receive, which in turn increases demand.
So what has allowed UF Health to grow in a time when other academic health centers are struggling? A lot of things, Guzick says.
UF Health physicians have become more integrated in the community, serving local patients as well as those who travel from across the state and country for specialty care. Another strategy that has helped UF Health expand is a focus on securing private resources for construction instead of solely relying on shrinking state and federal funds.
But overall, UF Health leaders think that the seeds planted when the hospital and the health center aligned under one strategic vision are bearing fruit.
“We like to think our overall strategy is working,” Guzick says. “Our fundamental strategy is unleashing the power of the Health Science Center when faculty are working in close collaboration with the hospital. That concept drives the conversation. It isn’t about what is best for a specific faculty member or the hospital — it is about what is best for the health system as a whole.”
Inside the growth …
Lake Nona
In November 2012, UF opened the UF Research and Academic Center at Lake Nona in Orlando. A hub for research and education in the Orlando area, the new center allows UF researchers to discover new collaborations — with experts at Nemours and the Sanford-Burnham Medical Research Institute — but also allows people in the region to more easily participate in academic research.
In an effort to bring a first-of-its-kind lab in an in-demand area of science to the campus, UF recruited former Food and Drug Administration researcher Larry Lesko, Ph.D., to establish the new Center for Pharmacometrics and Systems Pharmacology. Lesko’s team uses mathematical modeling and simulation to answer questions about medications for industry and researchers involved in drug development. They can devise tests to find out what is causing drugs to interact with each other. They can help researchers design the most effective clinical trials that require the least number of patients to participate. They can figure out how to scale down an adult dose of medication to one suited for a child, all before it ever reaches a patient. And these are just a few of the types of projects Lesko and his team can handle.
“We have a toolkit of mathematical techniques that we can use to answer these questions, for FDA, for pharmacological companies and for researchers on campus,” says Lesko, who left the FDA to establish the program at UF . “This type of work is a high priority for the future. We are developing a program that doesn’t exist anywhere. There is no formal education to train pharmacists and scientists to use these tools.”
Being at Lake Nona, surrounded by experts in an array of disciplines while still being part of the broader UF community, has allowed Lesko and his team to establish beneficial partnerships, as well.
“We apply joint expertise to answer these questions,” he says. “No discipline is a silo.”
Lake Nona also serves as a home for the College of Pharmacy’s students in Orlando and provides opportunities for them to participate in research without having to travel to Gainesville, as well as unique patient care opportunities like the Medication Therapy Management program.
The College of Pharmacy’s Medication Therapy Management program was established to provide over-the-phone medication therapy management services to patients who receive Medicare Part D prescription benefits. The goal is to help patients better understand the purpose of their medications and to help prevent medication- related adverse events and complications.
“It’s a clinical conversation that goes on with the patient,” says Karen McLin, Pharm.D., director of the MTM program.
Because of the growing need for these skills, College of Pharmacy leaders wanted to ensure that more students received medication therapy management experience so they expanded the program beyond Gainesville to Lake Nona. The second MTM center opened in August 2012.
As a result, the call center has since been able to broaden its capacity of providing medication therapy management and other services for patients beyond those receiving Medicare Part D.
“We are able to reach a lot more patients now and we feel it is our privilege to be able to help them,” McLin said.
The Clinical and Translational Research Building
The goal of UF ’s Clinical and Translational Science Institute is simple — reduce the time between research in the lab and treatments in patients. This summer, UF opened a new building that will help that simple idea become reality. The new Clinical and Translational Research Building, a $45 million, 120,000-square-foot facility, is home to the CTSI and UF ’s Institute on Aging, bringing together researchers from across the disciplinary spectrum, a move that UF leaders say will foster new ideas and help speed discoveries to patients.
One of the many novel programs housed in the building is the CTSI ’s new Clinical Research Center. The center serves as a home for studies spanning all age groups and in everything from diabetes and Pompe disease to kidney disease and hepatitis, ranging from Phase 1 trials that screen for safety to Phase 3 trials that confirm that treatments are safe and effective for humans.
“The goal of the CTSI is to bring discovery into clinical practice, and what the CRC does is enable the translation of some of those discoveries,” says Desmond Schatz, M.D., director of the Clinical Research Center and a UF professor of pediatrics.
Previously, individuals participating in the CRC ’s clinical trials had to be seen in the hospital, which could be less convenient for participants coming for quick outpatient visits. Now, participants come to the new Clinical and Translational Research Building for outpatient visits — CRC research studies requiring inpatient facilities will still be conducted in the hospital.
In Schatz’s case, the nurses and research coordinators who work with him on research in the UF Health Diabetes Center of Excellence all worked in different buildings and trekked to the hospital to see research participants. Now, the nurses and coordinators have all moved to the new building, giving them better access to participants and allowing them to use their time more efficiently, Schatz says.
Medical Education Building
Last year, the UF College of Medicine unveiled a new curriculum emphasizing collaborative learning in small groups and incorporating clinical experiences earlier in students’ education.
The goal is to produce medical students with advanced clinical skills who are prepared to work in teams. It was a big step forward. The problem? The facilities don’t quite match up to the aims of the curriculum.
Enter the new Medical Education Building, a facility that has been in the works for years and is now set to become a reality, with the help of donations. UF will break ground on the facility, which will be located next to the Health Professions/ Nursing/Pharmacy Complex, on Nov. 22.
“One of the major emphases is to create a learning environment that fosters collaborative and team-based learning,” says Joseph Fantone, M.D., senior associate dean for educational affairs in the College of Medicine.
The new building will feature two large learning studios, where students can sit in small groups and apply what they have learned. In addition, the building will feature an advanced simulation space with an experiential learning center and a clinical skills area where students will learn how to do exams and work with “standardized” patients — volunteers who pose as patients. The building also will house hospital rooms and operating rooms that mirror those in the UF Health Shands Cancer Hospital.
“One of the things that is attractive about this is it will help the hospital orient new employees, too,” Fantone says. “This will be a hub for other health science students, as well. As we look toward the future there will be more and more interprofessional team training.”
In addition, all student services and programs will be housed under one roof, making it easier for students to navigate from one office to another. Meeting rooms and meeting areas are also placed throughout the building to encourage interaction between medical students, physician assistant students and faculty members.
The building is set to open in 2015.
UF Health Shands Children’s Hospital
Children have special needs, and so do families whose children are staying in the hospital. UF Health is working on meeting those needs with its renovations of the UF Health Shands Children’s Hospital.
UF Health began these efforts two years ago with the opening of the pediatric emergency department. Now, UF Health is in the process of an overhaul that will result in a 200-bed hospital dedicated to children’s care.
Following on the heels of upgrades made to the obstetrical unit, renovations will be made to the neonatal intensive care unit.
Enhancements are also being made to the entrance, the lobby, the exterior of the hospital, and of course, the new cardiac intensive care unit, which will feature large rooms with private bathrooms on the 10th floor of the hospital.
McKenna’s mother, Alyssa Brown, says parents and patients appreciate the special attention being given to children’s cardiac care.
“I think it will completely change the experience for families who need to stay at the hospital for heart-related issues,” she says.
A timeline of growth
8-2009: UF Health Family Medicine – New Berlin
11-2009: UF Health Shands Cancer Hospital
1-2010: UF Emerging Pathogens Institute
1-2010: UF Health Bariatric Surgery – Emerson
5-2010: UF Biomedical Sciences Building
1-2011: UF Health Family Medicine – Monument Landing
7-2011: UF Health Shands Pediatric E.R.
8-2011: UF Health Shands Chest Pain E.R.
8-2011: UF Health Family Medicine – Crossroads
2-2012: UF Health Cardiovascular Center – Emerson
7-2012: UF Health Psychiatry – Dupont Station
7-2012: UF Health Family Medicine – Main
7-2012: UF Health Florida Recovery Center
9-2012: UF Health Total Care Clinic – Jacksonville
11-2012: UF Health Family Medicine – Jonesville
11-2012: UF Research and Academic Center at Lake Nona
12-2012: UF Health Springhill
6-2013: UF Health Aesthetic and Head & Neck Surgery – Southside
8-2013: UF Health Shands Emergency Center – Springhill
8-2013: UF Health Pediatrics – Magnolia Parke
8-2013: UF Clinical and Translational Research Building
2014: Renovations to UF Health Shands
Children’s Hospital (scheduled)
2015: UF Health Jacksonville North (scheduled)
2015: Medical Education Building (scheduled)
2018: UF Health Specialty Tower (scheduled, tentative)